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  • Atherectomy angioplasty catheters that pulverize atheroma into fragments small enough to be aspirated or removed through the reticuloendothelial system; they are not used in the removal of plaque. These catheters usually include a flexible atherectomy device with a variable sized (1.25 to 6.0 mm) metal burr on the distal tip; the burrs are studded with multiple diamond chips that function as microblades. The burr rotates at 100,000 to 200,000 rpm and tracks along a central guide wire, which must first traverse the lesion before rotational atherectomy can proceed. Certain catheters have also been used that use atherectomy devices with a distal cam tip attached to a central drive shaft that revolves at high speed (e.g., 100,000 rpm) and seeks the path of least resistance. Ablative atherectomy catheters are designed to treat hard, calcified atheroma and diffusely stenotic lesions, including total occlusions if the central guide wire can traverse the lesion.
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